Slow and Steady

"There is no royal road to anything.  One thing at a time, all things in succession.  That which grows fast, withers as rapidly.  That which grows slowly, endures."
                                                                                   - Josiah Gilber Holland

I am not the most patient person in the world and although I appreciate that Veronica is doing well, I am anxious for more progress to occur.  I sometimes have to remind myself that each day is progress - each day she continues to grow and get stronger.  The doctors continue to have positive comments on her progress.   Today the attending neonatologist said she was doing "great" and the fellow said she was doing "remarkably well."  These are comforting statements but they don't change the unfortunate fact that Veronica has been in the NICU for two months and still has another one - two months to go before she can come home. 

There are several important steps that need to occur before any consideration is given to discharge.  One of the first ones is being able to feed by mouth.  Currently she is fed through a tube that goes directly into her stomach.  Her feedings are over the course of an hour.  When she is around 34 weeks gestational age (next Thursday) consideration will be given to introducing a bottle.  Unfortunately, breastfeeding would be difficult at this point and is not recommended by the NICU staff.  The lactation consultant has assured me that nursing will be possible somewhere down the road.  Until then, I'll continue pumping, and pumping and pumping..... 

Veronica will also need to be off of CPAP (continuous positive airway pressure).  The CPAP is used to keep her lungs inflated.  It also has the added benefit of growing lung tissue.  As we understand it, the longer she is on CPAP, the better she will do when she comes off of it.  So basically they are in no rush to wean her.  The other piece is that she needs to no longer require supplemental oxygen.  Her oxygen requirement has been low lately and today she was at 21% which is essentially room air which is excellent progress.  When Veronica reaches approximately 1600 grams, they will likely begin to wean her off of the CPAP.  Right now she is at 1420 grams. 

Veronica will also need to be able to regulate her temperature.  We can expect this to occur when she is approximately 1800 grams.  This is when she will be moved out of the isolette. 

Finally, she will need to no longer have episodes of apnea (when she stops breathing) or bradychardia (whe her heart rate drops).  As I understand it, most premature babies grow out of these "a's and b's" by their due date but potentially she could be discharged with an apnea monitor.

So there are several more hurdles to overcome.  And the progress will be slow, but steady.......